Rheumatoid arthritis is an autoimmune disease, a disorder in
which the body attacks its own healthy cells and tissues. When someone has
rheumatoid arthritis, the membranes around his or her joints become inflamed
and release enzymes that cause the surrounding cartilage and bone to wear away.
In severe cases, other tissues and body organs also can be affected.
Individuals with rheumatoid arthritis often experience pain,
swelling, and stiffness in their joints, especially those in the hands and
feet. Motion can be limited in the affected joints, curtailing one’s ability to
accomplish even the most basic everyday tasks. About one-quarter of those with
rheumatoid arthritis develop nodules (bumps) that grow under the skin, usually
close to the joints. Fatigue, anemia (low red blood cell count), neck pain, and
dry eyes and mouth can also occur in individuals with the disease.
In every issue of WebMD the Magazine, we ask our experts to answer readers' questions about a wide range of topics. In our May 2011 issue, a reader with rheumatoid arthritis asked WebMD's rheumatology expert, Scott Zashin, MD, why her husband doesn't help her more.
According to the National Institute of Arthritis and
Musculoskeletal and Skin Diseases, it is estimated that about 2.1 million
people in the United States have rheumatoid arthritis. The disease occurs in
all racial and ethnic groups, but affects two to three times as many women as
men. Rheumatoid arthritis is more commonly found in older individuals, although
the disease typically begins in middle age. Children and young adults can also
What Is Juvenile Rheumatoid Arthritis?
Juvenile rheumatoid arthritis occurs in children 16 years of
age or younger. Children with severe juvenile rheumatoid arthritis may be
candidates for glucocorticoid medication, the use of which has been linked to
bone loss in children as well as adults. Physical activity can be challenging
in children with juvenile rheumatoid arthritis, since it may cause pain.
Incorporating physical activities recommended by the child’s doctor and a diet
rich in calcium and vitamin D are especially important, so that these children
can build adequate bone mass and reduce the risk of future fracture.
What Is Osteoporosis?
Osteoporosis is a condition in which the bones become less
dense and more likely to fracture. Fractures from osteoporosis can result in
significant pain and disability. It is a major health threat for an estimated
44 million Americans, 68 percent of whom are women.
Risk factors for developing osteoporosis include:
thinness or small frame
family history of the disease
being postmenopausal or having had early menopause
abnormal absence of menstrual periods (amenorrhea)
prolonged use of certain medications, such as glucocorticoids
low calcium intake
excessive alcohol intake.
Osteoporosis is a silent disease that can often be prevented.
However, if it goes undetected, it can progress for many years without symptoms
until a fracture occurs.
The Rheumatoid Arthritis – Osteoporosis Link
Studies have found an increased risk of bone loss and fracture
in individuals with rheumatoid arthritis. People with rheumatoid arthritis are
at increased risk for osteoporosis for many reasons. To begin with, the
glucocorticoid medications often prescribed for the treatment of rheumatoid
arthritis can trigger significant bone loss. In addition, pain and loss of
joint function caused by the disease can result in inactivity, further
increasing osteoporosis risk. Studies also show that bone loss in rheumatoid
arthritis may occur as a direct result of the disease. The bone loss is most
pronounced in areas immediately surrounding the affected joints. Of concern is
the fact that women, a group already at increased osteoporosis risk, are two to
three times more likely than men to have rheumatoid arthritis as well.